This factsheet is for people who have tuberculosis, or who would like information about it.
Tuberculosis is an infection caused by the bacteria Mycobacterium tuberculosis. It most commonly affects the lungs but can affect other parts of your body as well, such as the bones or lymph nodes.
At present, a third of the world’s population (more than 2 billion people) are infected with the bacteria that cause tuberculosis. However, only one in 10 infected people will show signs of the disease. This is known as active tuberculosis. In the UK in 2009, over 9,000 people were reported to have active tuberculosis. Although the number of people getting tuberculosis had been dropping since the 1950s, this number has been increasing again each year since the late 1980s.
Tuberculosis occurs most often in major cities. This is because there are more risk factors for tuberculosis in cities, such as overcrowded housing and more people arriving from countries where there is a higher rate of tuberculosis. In the UK, tuberculosis can be treated easily with antibiotics, although you will need to take these for some time. In other parts of the world there are far more people with the active disease. Tuberculosis is the second leading cause of death from an infectious disease worldwide, after HIV/AIDS.
You may or may not have any symptoms depending on how your body reacts to the tuberculosis infection. Once you have been infected with the tuberculosis bacteria, one of three things could happen.
If you have any symptoms of tuberculosis in your lungs, these can include:
You may have tuberculosis infection in a part of your body other than your lungs. Your symptoms will depend on where the infection is. You may have:
These symptoms aren’t always caused by tuberculosis, but if you have them, see your GP.
You can be infected with tuberculosis bacteria when someone who is already infected coughs or sneezes. This produces droplets containing the bacteria that are then dispersed in the air. These bacteria can survive for long periods of time outside the body. If you breathe in the bacteria that are in the droplets, they will usually begin to grow and multiply inside cells in your lungs. If they enter your blood, they can be transported to other organs, such as your brain or stomach, and start growing in these parts of your body as well.
You’re at a higher risk of catching tuberculosis if you:
However, tuberculosis isn’t spread by:
If you think you have tuberculosis, see your GP, who will ask you about your symptoms and examine you. He or she may also ask you about your medical history. If your GP thinks you have tuberculosis, he or she will carry out some tests to confirm this. You may need to be referred to a specialist team at a chest clinic for some of these.
Your GP can arrange the following tests for you.
Tests that might be carried out by your doctor at the specialist chest clinic are described below.
Treatment for tuberculosis usually involves taking antibiotics every day for six months. The reason for the long course of treatment is because the bacteria that cause tuberculosis are often in a dormant state (not growing or multiplying). Antibiotics work best on bacteria that are growing and multiplying, so in order to try to kill all the bacteria, a long course of treatment is needed.
The treatment involves using different antibiotics to help prevent the bacteria becoming resistant – this means that the antibiotics become less effective. You’re likely to be given four different antibiotics to take every day for two months. After this you will be given two different antibiotics to take daily for the next four months.
If you think you will have trouble remembering to take your medicine every day, you can be referred to a specialist team who will give you your tablets three to four times a week, and you will take the tablets under their supervision. Talk to your doctor about the best way to make sure you get the right treatment.
Always ask your doctor for advice and read the patient information leaflet that comes with your medicines.
Sometimes, resistance can start when the bacteria causing an infection aren't completely killed off by an antibiotic. Some bacteria survive because they have a genetic mutation that helps them resist the treatment. The few bacteria that survive can then multiply, causing an infection that is resistant to that particular antibiotic.
There are different levels of drug resistance that can happen in tuberculosis treatment.
Getting these types of tuberculosis is more likely if you don’t take the full course of antibiotics in the way these were prescribed for you. A failed course of antibiotics increases the chance that tuberculosis will come back again and be more difficult to treat.
In the UK, there used to be a vaccination program against tuberculosis that involved giving school children the BCG injection before they were 14 years old. This program has now been stopped because rates of tuberculosis have dropped to a very low level in the UK population. At present, only people in at-risk groups are offered the vaccine. You’re likely to be offered the BCG vaccination if you:
Children are likely to be offered the BCG vaccination only if their family live in an area with a high rate of tuberculosis infection, or if their parents or grandparents were born in a country with a high rate of tuberculosis infection.
If you’re diagnosed with tuberculosis, staff at your chest clinic can arrange for your close contacts to be traced. This is important so that they too can be tested and treated if needed.
For answers to frequently asked questions on this topic, see FAQs.
For sources and links to further information, see Resources.
This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the about our health information page.
Produced by Louise Abbott, Bupa Health Information Team, January 2012.
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